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This blog is a platform for me to share all my lecture notes on Midwifery Nursing. Hope this will be useful to all the nursing students out there! Happy Reading!

Friday, 20 July 2012

Physiology of Reproduction

Function of the female reproductive system.

At puberty the ova begins to mature. At the follicular
phase, an ovum matures within a cyst called “Graafian follicle” until it
reaches the surface of the ovary where rupture occurs. The ovum is discharged
into the peritoneal cavity. This periodic liberation of matured ovum into the
peritoneal cavity is referred to as ovulation. This ovum finds its way
into the fimbriated end of thefallopian tube. On its way to the uterus,
if it meets a spermatozoan,the male gamete and union occurs and
conception or fertilizationtakes place. The empty Graafian follicle,
after ovulation is called as corpus luteum (yellow body), which secretes
progesterone, a hormone that prepares the uterus for receiving the fertilised
ovum.

Female hormones:

The ovaries produce steroid hormones, estrogen and
progesterone.

Oestrogen:

It is responsible for development and maintenance of the
female reproductive organs and the secondary sexual characteristics associated
with the adult female. Estrogen also plays an important role in breast
development and in monthly cyclic changes (menstrual cycle) in the uterus.

Progesterone:

Progesterone regulates the changes that occur in the
uterus during the menstrual cycle. It is secreted by the corpus luteum.
Progesterone is important for conditioning the endometrium in preparation for
implantation of the fertilised ovum. If the pregnancy occurs, progesterone is
essential for maintaining a normal pregnancy. In addition, it works along with
oestrogen in preparing the breast for secretion of milk.

Physiology of reproduction:

Menstrual cycle or uterine cycle:

It is a series of changes in the uterus resulting in the
discharge of blood from the vagina each month. Menstruation can be defined as,
“sloughing and discharge of the lining of the uterus if conception does not
take place.” This time varies in different women and also from time to time-in
same woman. The first day of the cycle is the first day when bleeding begins.
The ovarian hormones control the menstrual cycle. There are three main phases
and they affect the tissue structures of the endometrium. The average time of
menstrual cycle is 28 days and recurs regularly from puberty to menopause
except in pregnancy. The three phases are:

1. Proliferative phase: Follicular stimulating
hormonal level increases in blood, stimulating oestrogen secretion, which
causes the endometrium to thicken and become more vascular. This phase follows
menstruation and lasts until ovulation.

2. Secretary phase: The secretary phase follows
ovulation and is under the influence of progesterone and oestrogen from the
corpus luteum. Leutinising hormone level increases in blood. Under the combined
stimulus of estrogen and progesterone, the endometrium reaches the peak of its
thickening and vascularisation.

3. Menstrual phase: It is characterised by vaginal
bleeding, lasts for 3 – 5 days. On absence of fertilization, the thickened
endometrium is shedded. Two Gonadotrophic hormones are released by the anterior
pituitary gland. They are:

-Follicular stimulating hormone:FSH is primarily
responsible for stimulating the ovaries to secrete oestrogen and for maturation
of ovum.

-Luteinising Hormone (LH): LH is primarily
responsible for stimulating the corpus luteum for productoin of progesterone.

3. Puberty: This is the period in which, the
reproductive organs develop and reach maturity. The first signs are breast
development and appearance of pubic hair. The body grows considerably and takes
on the female contour. Puberty culminates in the onset of menstruation, the
first period being called menarche. The first few cycles are not
accompanied by ovulation. Puberty usually occurs between 12 and 14 years.

Menopause: It is the end of a woman’ s reproductive
life, characterised by the gradual cessation of menstruation. The period first
becomes irregular and then ceases altogether. This occurs between the ages of
45 to 50. It is the normal part of aging and maturation. Menstruation ceases
because the ovaries are no longer active. No more ovarian hormones are
produced. The reproductive organs become atrophied.

Fertilization: Following ovulation, the ovum about
(0.15 mm) in diameter passes into the fallopian tube and moves towards uterus.
If coitus takes place at this time, the alkaline mucus attracts the
spermatozoa. About 300 million sperms are deposited in the posterior fornix of
the vagina. Those which are propelled by the cervical mucus reach the fallopian
tube and others are destroyed by the acid medium of the vagina.

The matured sperm is capable of producing the enzyme
hyaluronidase, which allows the sperm to penetrate the cell membrane,
surrounding the ovum. Many sperm are needed for this, but only one will enter
into the ovum and fertilisation occurs. After this, the membrane is sealed to
prevent the entry of any further sperm and the nuclei of the two cells fuse.
The sperm and the ovum each contribute half the complement of chromosomes to
make a total of 46. The sperm and ovum are known as the male and female
gametes. The fertilized ovum is known as the zygote. Implantation of the
fertilised ovum (embedding) into the uterine cavity (endometrium) is called as
nidation or nesting. Normally this occurs by the 11th
day after ovulation and the endometrium closes over it completely.

Development of the fertilised ovum:

Fertilised ovum reaches the uterus by 3-4 days. Cell
division takes place as 2 into 4,8,16, etc, till a cluster of cells formed
known as morula (mulberry). Next a fluid filled cavity, a blastocele appears in
the morula and it is known as blastocyst. Outside of blastocyst there is a
single layer of cells known as trophoblast, while the remaining cells
are clumped together forming an inner cell mass. The trophablast forms
the placenta and chorion while the inner cell mass become fetus
and amnion.

Formation of fetal membrane and placenta:

The trophoblast has two layers,

·
Outer syncitiotrophoblast, which erodes the endometrium in the
process of embedding.

·
The inner cytotrophoblast produces a hormone called human
chorionic gonadotrophin (HCG) which reacts on corpus lutuem to continue the
pregnancy by producing oestrogen and progesterone.The trophoblast develops as
placenta which will nourish the fetus until delivery.

The inner cell mass differentiates into three layers.

From
the ectoderm skin and nervous system are formed.

From
the mesoderm bones and muscles, heart and blood vessels and certain
internal organs are formed.

From
the endoderm mucous membranes and glands are formed.

During the first three weeks following conceptual the fertilised
ovum is termed as zygote. From 3-8 weeks, it is termed as embryo.
The organs and systems are developed by 7th week.
After 8 weeks, till birth it is termed as fetus.

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You actually make it seem so easy with your presentation but I find this topic to be actually something that I think I would never understand.It seems too complex and very broad for me. I'm looking forward for your next post, I'll try to get the hang of it!

Heya just wanted to give you a brief heads up and let you know a few of the images aren't loading properly.I'm not sure why but I think its a linking issue. I've tried it in two different web browsers and both show the same outcome.